Developments & dynamics
Public health and the health sector at large are faced with many challenges due to the shortcomings in the health system, the upcoming constitutional changes and continuous scarcity of financial funds. The Island government recognizes the following policy accents that are reflected in the various policy documents such as the Governing program, the "Slotverklaring Ronde tafel Conferentie, "Building a healthy Island", "Health care services St. Maarten", St. Maartens Strategic HIV/AIDS plan and the recently approved organization plan for the future Ministry of Public health and Social development.
– The need to review, and develop public health and health care legislation for the Country of St. Maarten due to the fact that all responsibilities with regards to the supervision, financing, policy & legislation and structure of public health and health care services will be transferred to the island.
– The need to build capacity for the decentralization process and the future Ministry of Public health and Social development .
– The priority to develop a National health insurance plan for all residents of St. Maarten, as a way to solve inefficiencies and find solutions to ensure the availability and access to health care services. This also in light of the many illegal immigrants .
– The need to develop integrated policies with other governmental sectors and/or future ministries such as ROB, Education, Sports, Economic Affairs and Social development. Certain public health areas can only be addressed effectively in collaboration with other policy sectors .
– The need to develop our public health infrastructure and health promotion to address and give improvement to health and environmental hygiene problems .
– The development of guidelines and policies to maintain and improve the quality, establishment and accessibility of health care services .
– The need to achieve cost containment in health care through the introduction of a new financing system for health care in addition to already existing needs to develop budgeting systems and Financial Overviews Health care (FOG).
– The need to develop prevention activities aimed at health promotion and education pertaining to lifestyle, eating habits, overweight and exercise.
– The need to promote primary health care and further develop multi-disciplinary cooperation between health care services and the introduction of accompanying managed care concepts to improve quality and contain costs in healthcare.
– The necessity to further strengthen Essential Public Health Functions, in order to improve areas such as epidemiology and surveillance, health information, food safety, quality of drinking water, youth health care, medical relief in disasters. Especially health information and disaster management will be recognized this year.
In addition to these health priorities as set in the mentioned important documents, the Executive Council and Federal government made critical decisions that will influence the selected activities of Sector Health Care Affairs. Critical decisions are for example:
1. The availability of a new integrated facility for the ambulance and fire department.
2. The support and financing of the expansion of SMMC’s care & services.
3. The approval of St. Maartens Strategic HIV/AIDS plan 2007-2011.
4. The execution of a drugs survey.
5. The introduction of an expanded Surveillance system for CD’s.
6. The introduction of federal legislation for Quality of drinking water (Drinkwaterverordening) and a surface water monitoring program.
7. The introduction of the Federal legislation " Instellingen gezondheidszorg" and a licensing system for health care institutions
8. The development of a national health insurance plan (AZV) for country Sint Maarten.
9. The approval of an automated system and plan of action for the administrative organization of the Ambulance services.
10. The introduction of an expanded Youth dental care program.
11. The development of a nutrition and exercise policy.
12. To decentralize Federal governmental tasks to the Island territories in 2009.
13. The development of governmental complaint procedures and – websites.
14. To reorganize and integrate the department ARSOZA with SHCA’s.
15. The recruitment of a financial controller for SHCA’s new staffbureau.
These policy priorities will continue to influence the strategic outlook of Sector Health Care Affairs for the year 2009.
If St. Maarten will have full responsibilities in the area of Public health policy-making and legislation, more is needed in health research to improve informed decision making in the near future. As a result of this, our budget 2009 continues to place more emphasis on the importance of health research. In addition, we believe that preparations needs to be made for a ‘new’ ‘How healthy is St. Maarten’ (10 years after execution in 1999).
With the availability of a new integrated facility for the fire department and ambulance services, we expect a ‘new esprit’ of professionalism and this will be reflected in the expansion of the ambulance shifts and the introduction of quality assurance programs and protocols as required in the Lvo Zorginstellingen.
The third component of budgetary adjustments is related to public health initiatives for current concerns related to health promotion and environmental health. Lifestyle (STI’s, nutrition and exercise) and man-made problems will continue to seize SHCA’s attention and 2009 will also serve as a year for intensified preventive and supervisory activities in the area of sanitary inspections. Another new initiative in the area of the Hygiene & Veterinary department is related to the monitoring of the quality of surface waters such as ponds and beaches.